Study Questions:

Does an individual’s perception of the need to improve physical health predict the adoption of healthy behaviors?

Methods:

Data from the 2011-2012 Canadian Community Health Survey, a cross-sectional survey of Canadians ≥12 years conducted by the Statistics Canada, were used for this analysis. Items that relate to nine modifiable cardiovascular risk factors were considered. These factors were smoking, history of hypertension, diabetes mellitus, abdominal obesity, psychosocial factors, daily consumption of fruits and vegetables, regular alcohol consumption, regular physical activity, and a raised apolipoprotein (Apo)B/ApoA1 ratio. Perceived need to improve physical health was defined as an affirmative answer to the question: “Do you think there is anything you should do to improve your physical health?”

Results:

A total of 45,443 respondents were included in the present study. The sum of potentially modifiable risk factors was positively associated with perceived need for improving physical health. Smoking, obesity, and low physical activity were most strongly associated with perceived need for improving physical health, whereas hypertension and diabetes mellitus were not associated with perceived need for improving physical health. Barriers to adopting healthy behaviors were reported by 55.9% of individuals endorsing perceived need for improving physical health. Almost 20% of individuals with the highest risk for heart disease did not perceive need for improving physical health.

Conclusions:

The authors concluded that the cumulative burden of potentially modifiable risk factors is positively associated with perceived need to improve physical health. A significant number of individuals at highest cardiac risk did not perceive a need for improving physical health.

Perspective:

These data suggest that many adults at increased risk for cardiovascular disease do not feel a need to improve their health. Having diabetes and/or hypertension was not associated with a perceived need to improve health. Interventions that improve patients’ understanding of the benefits of improving physical health may significantly improve patients’ motivation for lifestyle change. In addition, understanding barriers to change will be important, given that over 50% of this population reported barriers to improving physical health.